Collaborative drugs management "reduces errors by nearly 80%"

A new, more collaborative approach to medicines management for hospitalised patients has been shown to reduce medication errors by nearly 80%.

The study, reported in the British Medical Journal Quality & Safety, says this collaborative approach between doctors and hospital pharmacists resulted in a 78% reduction in the number of patients experiencing medication error at admission and a 79% reduction at discharge.

It also entirely eliminated potentially severely harmful medication errors, compared with an incidence of 6% of patients receiving the standard model of care. And it improved the quality of prescribing in older patients by facilitating better communication about their drugs, which is a particularly important factor given the increase in polypharmacy among older patients, say the authors.

The study was conducted by researchers from the School of Pharmacy and Pharmacy at Trinity College Dublin in collaboration with the medical directorate and the pharmacy department at Tallaght Hospital, South Dublin.

“The involvement of hospital pharmacists in team-based clinical activities at the bedside in Irish hospitals is rare,” says the study’s lead author Dr Tamasine Grimes, associate professor in the practice of pharmacy at Trinity.

“This study showed that providing team-based care, involving the doctor and the pharmacist from admission through to discharge, significantly improves patient safety and the quality of prescribing. Improved prescribing is known to cause a decrease in healthcare use and costs, not to mention the potential for keeping patients safe,” she says.

The Collaborative Pharmaceutical Care at Tallaght Hospital (PACT) service was delivered at admission, during hospital care and at discharge, with a pharmacist working with the medical team.

In standard care, a hospital pharmacist worked on a particular ward and was involved at admission and during hospital stay but not at discharge, and would not have had the same degree of communication and collaboration with doctors as they did in the PACT approach, say the researchers.

Admission and discharge from hospital are vulnerable times for patient safety, says Dr Grimes. A lot of complex information needs to be shared between healthcare providers, and the chance for miscommunication is “high.”

“More and more, the patients who present to our hospitals are already using multiple prescribed medicines. This adds to the challenge of keeping them safe and preventing medication error,” she says.

Dr Catherine Wall, clinical director of medicine at Tallaght Hospital, said the study provides “valuable information about how to improve medication safety for hospitalised patients. Team working between doctors and pharmacists, with a focus on managing medicines, improves the quality and safety of medication use.”